Bidirectional associations between psoriasis and migraine: A systematic review and meta-analysis

Background and Objectives: To evaluate the association between psoriasis and migraine. Patients and Methods: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant observational studies from their respective inception to May 1, 2022. A random- effects model meta-analysis was performed to calculate the risk estimates quantifying the associations between psoriasis and migraine. We also performed a sensitivity analysis by including only studies with adjusted risk estimates and a subgroup analysis according to the severity of psoriasis. Results: We included 9 studies with 6,742,075 participants. The meta-analysis illustrated increased odds for prevalent migraine among patients with psoriasis (pooled OR: 1.69, 95% CI: 1.26-2.28) and increased odds for prevalent psoriasis among those with migraine (OR: 1.88, 95% CI: 1.32-3.67). A subgroup analysis of cohort studies demonstrated an increasingly higher risk of incident migraine in patients with mild psoriasis and severe psoriasis (IRR being 1.37 (95% CI 1.30-1.44) and 1.55 (95% CI 1.29-1.86), respectively). Conclusions: This meta-analysis revealed significant bidirectional associations between migraine and psoriasis. Greater severity of psoriasis appears to be associated with a higher risk of developing migraine. Clinicians should evaluate symptoms of migraine in patients with psoriasis and provide proper treatments.